Punjab

Ludhiana

CC/19/568

Kamaldeep Singh - Complainant(s)

Versus

Shriram General Insurance Co.Ltd - Opp.Party(s)

sukhwinder Singh Adv.

17 Aug 2022

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.

                                                Complaint No:568 dated 12.12.2019.                                                         Date of decision: 17.08.2022.

 

Kamaldeep Singh S/o. Harwinder Singh, R/o. H. No.377/382, Adarsh Nagar, Sector 32, Samrala Road, Ludhiana.                                                                                                                                         ..…Complainant 

Versus

 

1. Shree Ram General Insurance Co. Ltd., E-8, EPIP RILCo Industrial Area, Sitapura, Jaipur, Rajasthan-302022 through its Chairman/Director.
2. Shree Ram General Insurance Co. Ltd., SCO 18-19, 3^rd Floor, Jandu Tower, Ludhiana-141003 through its Manager/Authorized Person.                                                                               …..Opposite parties 

Complaint under Section 12 of the Consumer Protection Act, 1986.

QUORUM:

SH. K.K. KAREER, PRESIDENT

SH. JASWINDER SINGH, MEMBER

 

COUNSEL FOR THE PARTIES:

For complainant             :         Ms. Sushmita, Advocate.

For OPs                          :         Sh. Vyom Bansal, Advocate.

 

ORDER

PER K.K. KAREER, PRESIDENT

1.                In brief, the case of the complainant is that he got his car bearing registration No.PB-10-EF-1245 comprehensively insured from the OPs vide policy No.105029/31/18/003456 which was valid from 27.07.2017 to 26.07.2018. Unfortunately, the insured car met with an accident on 24.02.2018. After the accident, the complainant got his vehicle towed to M/s. Benchmark Motors Pvt. Ltd., G.T. Road, Pawa, Ludhiana on 28.02.2018 through M/s.Raj Towing Service. The OPs appointed a surveyor who inspected the vehicle at the workshop of M/s. Benchmark Motors Pvt. Ltd.  On the instructions of the OPs and their surveyor, the said agency repaired the vehicle and raised a bill of Rs.1,01,915/-. The complainant submitted all the relevant documents to the OPs for getting the loss assessed. However, the complainant was surprised to receive the letter dated 31.05.2018 whereby the claim was repudiated by the OPs. The repudiation of the claim is illegal and amounts to deficiency of service on the part of the OPs. Even a legal notice dated 25.11.2019 served upon the Ops failed to evoke a positive response. Hence the complaint whereby it has been requested that the OPs be directed to pay the claim of Rs.1,01,915/- with interest @18% per annum along with compensation of Rs.2,00,000/- and litigation expenses of Rs.22,000/-.

2.                The complaint has been resisted by the OPs. In the written statement filed by the OPs, it has been, inter alia, pleaded that the intimation for claim of the damage to the car was received on 01.03.2018 at 06.40 PM and, therefore, the claim was registered and M/s. Vinod Kumar & Associates were appointed as surveyor. The surveyor visited the insured and clicked photographs etc. The surveyor required the documents, statement of insured and submitted his report dated 04.04.2018 assessing the liability of Rs.87,500/-. Thereafter, the OPs sent letter dated 16.04.2018 to the complainant to submit the documents detailed therein but no reply was received from the insured. The OPs sent reminders dated 09.05.2018, 21.05.2018, 25.05.2018 but the said letters were not responded to by the complainant nor the documents were submitted with the OPs. As a result, the claim was not found payable for the reasons mentioned in the letter dated 26.05.2018. The other allegations made in the complaint have been denied as wrong and a prayer for dismissal of the complaint has also been made.

3.                In evidence, the complainant has submitted his affidavit Ex. CA along with documents Ex. C1 to Ex. C7 and closed the evidence.

4.                On the other hand, the counsel for the OPs tendered affidavit Ex. RA of Sh. Amandeep Sharma, Legal of the OPs along with documents Ex. R1 to Ex. R8 and closed the evidence.

5.                We have heard the counsel for the parties and have gone though the record.  

6.                During the course of arguments, the counsel for the complainant has argued that the complainant had submitted all the documents with the OPs but the claim was repudiated vide letter dated 31.05.2018. The counsel for the complainant has contended that the complainant had submitted all the relevant documents with the OPs which were necessary for processing the claim but despite that the claim has been illegally repudiated.

7.                On the other hand, the counsel for the OPs has argued that the claim has been rightly repudiated as the factum of accident of the vehicle was itself doubtful. According to the counsel for the OPs, the accident took place on 24.02.2018 but the police was informed after a delay of 5 days. The counsel for the OPs has further contended that the vehicle was not found to have been hit from behind whereas the complainant had claimed that another vehicle hit the insured vehicle from behind on its right side. The counsel for the OPs has further contended that even otherwise the complainant failed to supply the necessary documents due to which the claim could not be paid. In this regard, the counsel for the OPs has referred to letter Ex. R7 dated 25.05.2018 written by the surveyor to the complainant asking for certain clarifications from the complainant. The counsel for the complainant has further contended that the complainant never responded to the said letter and eventually the OPs vide letter Ex. R8 dated 26.05.2018 informed the complainant that his claim could not be considered due to non-submission of certain documents. 

8.                We have weighed the contentions raised by the counsel for the parties and have gone through the record.

9.                In this case, the claim has not been repudiated in toto or on merits. Vide letter dated 26.05.2018, the OPs have claimed on one side that the surveyor has observed that the damage to the vehicle was not by external means and, therefore, the claim was not covered under the policy. At the same time, in the letter Ex. R8 dated 26.05.2018, it has been observed that the claim could not be considered for want of documents/clarifications such as detailed written statement of the driver about the accident, written statement of insured about the accident, spot photographs of the vehicle, running record/service record of the vehicle, any proof of accident, reasons for 5 days delay with supporting documents etc. Since the claim has not been repudiated on merits but not been considered for want of certain documents referred to in letter Ex. R8, it would be just and proper if the complainant is directed to supply the documents referred to in letter Ex. R8 dated 26.05.2018 to the OPs within a period of 15 days from the date of receipt of copy of order and on receipt of such documents, the OPs will decide the claim strictly in terms and conditions of the policy within 30 days thereafter.

10.              As a result of above discussion, the complaint is disposed off with a direction to the complainant to supply the documents referred to in letter Ex. R8 dated 26.05.2018 to the OPs within a period of 15 days from the date of receipt of copy of order and on receipt of such documents, the OPs will decide the claim strictly in terms and conditions of the policy within further 30 days from the date of receipt of documents from the complainant. Copies of order be supplied to parties free of costs as per rules. File be indexed and consigned to record room.

11.              Due to rush of work and spread of COVID-19, the case could not be decided within statutory period.

 

                             (Jaswinder Singh)                            (K.K. Kareer)

                    Member                                           President

 

Announced in Open Commission.

Dated:17.08.2022.

Gobind Ram.

Kamaldeep Singh Vs Shree Ram General Insurance Co. Ltd.    CC/19/568 

Present:       Ms. Sushmita, Advocate for the complainant.

                   Sh. Vyom Bansal, Advocate for the OPs.

 

                   Arguments heard. Vide separate detailed order of today, the complaint is disposed off with a direction to the complainant to supply the documents referred to in letter Ex. R8 dated 26.05.2018 to the OPs within a period of 15 days from the date of receipt of copy of order and on receipt of such documents, the OPs will decide the claim strictly in terms and conditions of the policy within further 30 days from the date of receipt of documents from the complainant. Copies of order be supplied to parties free of costs as per rules. File be indexed and consigned to record room.

 

                             (Jaswinder Singh)                            (K.K. Kareer)

                    Member                                           President

 

Announced in Open Commission.

Dated:17.08.2022.

Gobind Ram.